What's the best treatment for a fracture of the hamate bone in the wrist? Specifically, the little hook underneath the bone is broken off.
A little understanding of anatomy might help explain treatment choices. The hamate bone is one of the many small bones in the wrist. It lines up with the base of the fourth (ring) and fifth (baby) fingers. On the palmar side of the hand and wrist, the hamate bone has a projection of bone. This bit of bone is referred to as the hook of the hamate. There are many ligaments, muscles, and tendons that either attach directly to the hook of the hamate or sling around it like a pulley. If the hook is broken but not displaced (shifted away from the hamate bone), then immobilization is a cast or splint until it heals may be all that's necessary. But if the hook of the hamate has broken off and moved away from the bone, then surgery is required. The surgeon will repair the bone if possible. Sometimes it is necessary to remove the broken fragment of bone -- especially if it fails to heal (nonunion). Without surgery, the fractured hook can shift away from the hamate and become displaced. The jagged edges of the bone can cut through nearby tendons and ligaments. The result can be chronic pain, loss of motion, weakness, and eventual disability.
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